Studies on anaerobic infection in oro-maxillary region--rapid diagnosis by gas-liquid chromatography and antibiotic susceptibilities of anaerobic bacteria

Subject material for this study was pus collected from patients with purulent inflammation in the oro-maxillary region. Direct gas-liquid chromatography (GLC) analysis was made, bacterial isolation and identification were carried out, and comparisons were made with results from GLC analysis and anaerobic isolates in a PYG medium. In addition, antibiotic susceptibilities of anaerobic bacteria were examined. Results 1. Anaerobic bacteria were isolated from 85 of 100 cases of obstructive abscesses. Of the 85, 49 were cases of mixed infection involving both anaerobic and aerobic bacteria; and 64 cases were involved with more than 2 species of anaerobic bacteria. Of the 184 strains of anaerobic isolates, 53 were Bacteroides sp. and 51 were Peptostreptococcus sp. The 2 groups accounted for more than half of the isolates. 2. Group A, in which no VFA was detected, accounted for 17 out of 100 cases. Group B, in which acetic acid was detected, accounted for 20 cases; and Group C, in which butyric acid was detected, accounted for 20 cases; and Group D, in which iso-valeric acid was detected, accounted for 8 cases. Direct GLC analysis revealed iso-caproic and caproic acids in the 35 cases constituting Group E. 3. Whereas the percentage of anaerobic bacteria was 64.7% in Group A and 60% in Group B, significantly higher percentages were noted in Group C (95%), Group D (100%) and Group E (100%). The following species were isolated as major member in the groups; Group A--Streptococcus intermedius, Group B--Peptostreptococcus micros, Group C--Fusobacterium nucleatum, Group D--Bacteroides gingivalis, and Group E--Peptostreptococcus anaerobius. 4. In all cases, the sum of VFA produced in the PYG medium by anaerobic isolates was classified into Group A' to E'. Ratios of agreement between VFA as revealed by direct GLC and VFA as revealed by PYG.GLC were as follows: Group A-A'; 47.1%, Group B-B' and C-C'; 45%, Group D-D'; 87.5%, and Group E-E'; 62.9%. 5. In Group B, no propionic acid was detected. The 2 cases in which acetic acid occurred in a concentration greater than 14 x 10(-4) meq/ml belonged to Group B'. In Group C, no isobutyric acid was detected; and the 5 cases in which butyric acid was detected in a concentration of more than 7 x 10(-4) meq/ml belonged to Group C'. Varelic acid was not detected in Group D; and 7 out of the 8 cases in which iso-valeric acid, irrespective of concentration, was detected belonged to Group D'.(ABSTRACT TRUNCATED AT 400 WORDS)